National programmes are “necessary in Francophone countries and particularly in Congo where we have an outline plan which needs to be strengthened,” said pathologist Donatien Moukassa.

The cancer conference in Dolisie, southwestern Congo, from 18-21 December, agreed that cancer should be declared a public health disease on a par with malaria, tuberculosis and sickle cell disease.

“Fighting cancer requires substantial resources. Testing is expensive. In general, fewer than five patients in 10 have access to treatment," said Albert Mouelle Soné, Dean of the Faculty of Medicine and Pharmaceutical Sciences at the University of Douala, Cameroon.

"In Congo, a cancer patient, regardless of their social status, must pay at least 300,000 CFA francs (US$600) per month for treatment. It's huge," said oncologist Nkoua Mbon, noting that the average wage is $160.

Furthermore, African countries have so far largely failed to establish mechanisms to map cancer - there are insufficient records. "Until today there is no cancer registry in the DRC [a country of 60 million inhabitants]. We are fighting with the authorities to get it," said Jean-Marie Kasongo Mpolesha of the African Organization for Research and Education on Cancer (OAREC).

Judith Nsondé Malanda, an oncologist at Brazzaville’s University Teaching Hospital, told IRIN there were “barely 40” oncologists in Africa.